AABB Accredited?

[csjuarez]

Our lab director is questioning whether we should continue to be AABB accredited, or should save the additional cost (and headaches) of two very similar audits since the CAP Transfusion Medicine checklist is now almost identical to the AABB. On the other hand, our Blood Bank Medical director thinks the additional cost is warranted in order to have the additional, well respected credentials for our Blood Bank and hospital.

Is your blood bank accredited by CAP and AABB, or just one or the other? Have you recently (in the last several years) opted to discontinue AABB accreditation? What reasons did you have for your decision?

Thanks!

[L106]

Our institution was accredited by both CAP and AABB "since the beginning of time", but we dropped our AABB accreditation about 10 years ago. Two things triggered that:

1. Back when AABB started the "Quality Plan" riggamarole, we jumped on board. I spent an enormous amount of time and effort writing up and organizing our Quality Plan. When our next inspector walked in, she looked at our impressive array of Quality Plan Manuals lined up on our shelves and said, "Oh, I see you have the Quality Plan stuff. I haven't seen any of that material yet." and proceeded to complete the inspection without so much as touching our precious Quality Plan "stuff". Prior to that, we had several AABB inspections that were of poor quality (ie: very superficial or the occassional ridiculously picky.) (I know this is not typically the case, but it was our experience.)

2. AABB's annual fees for institutions starting doubling around that time, and lab management & hospital administration decided that the hospital wasn't getting enough benefit for the money it was costing us and they decided to drop our AABB accreditation and membership. I was not supportive of this decision, but I can honestly say that I don't think it has made a bit of difference in the quality of our Blood Bank Department.

I am an individual AABB member, so I try to keep up with current information (so the hospital gets all the benefits even though we are not an AABB institutional member.) However, I don't know what will happen it my future successor is not an AABB member.

[tbostock]

My employer dropped AABB a few years ago due to cost (prior to my working here). We are inspected by the Joint Commission, who essentially uses the AABB standards to inspect. So you have to be held to the same high standards without the cost of AABB dues. We are also inspected by the NYS Dept of Health, which is pretty intense. I also maintain an individual membership with AABB as L106 stated above.

P.S. As far as inspections, I would accept an AABB one ANY DAY rather than the grueling week-long Joint Commission one.

[kmh76]

We were both AABB and CAP accrediated until this year when we dropped our CAP inspections. CAP inspectors do not know enough about Blood bank to do a thorough inspection. At our last CAP inspection the inspector sat in the lab and watched the techs work. She never bothered to look at Procedure Manuals and did not want to go to the floors to observe Nursing giving a transfusion. In my opinion AABB inspectors are more qualified and have helped in the past by giving our Blood bank great suggestions on how do do certain things. We are also Joint Commission accrediated so I don't know if upper management will want to keep our AABB accrediation going forward. I think they should as Joint Commission ofter refers to AABB standards.I am very happy with AABB coming in to inspect our Blood bank

[bmarotto]

We also dropped our AABB accreditation around 10-15 years ago for similar reasons. We had a small whole blood and plateletpheresis program, performed therapeutic phlebotomy and apheresis, and was the tissue bank for the hospital at the time. We did all our own clerical work and scheduling of donor/patient appointments. We had 11 FTEs and it was difficult to keep up with the ever increasing Quality Management documentation requirements. The AABB fees were rising and we did not feel the inspections did anything to improve the quality of our services since we were already being CAP and FDA inspected. I asked administration to create a new position for a Blood Bank compliance officer but they did not go for it. At that point, the decision was made to drop AABB. We continue to purchase each new edition of the Technical Manual and the Standards and update our SOPs to comply with current practice standards. We have agreements to provide blood bank services for two dialysis centers and two rehab hospitals. We provide them with our CAP certificate and FDA registration as well as quarterly quality monitors. We have been told that we are providing them better service than their past providers, who were AABB accredited.

If our administration had agreed to a compliance officer, we probably would still be AABB accredited. For me, being a "jack of all trades" was not the best use of my time.

[Eagle Eye]

we are AABB & CAP accrediated.

[John C. Staley]

As a Transfuison Service and not a Blood Bank we elected to drop the AABB accreditation 5 or 6 years ago but maintained an associate membership which is all the benefits without the inspection. If we had still had a donor service then I could see the benefit of full membership but as a Transfuion Service it was hard to justify the expense when we were getting essentially the same inspection from CAP.

Most of the CAP inspectors I knew were also AABB inspectors so nothing was lost there and to be honest some of the worst, nit picky, superficial inspections my staff endured were AABB inspections. The bottom line is that "not all inspectors are created equal" so you can only pay your money and take your chances and hope for the best.

[L106]

We were both AABB and CAP accrediated until this year when we dropped our CAP inspections. CAP inspectors do not know enough about Blood bank to do a thorough inspection.

I assume you are not a hospital lab? (If you are, I assume that your whole lab dropped CAP accreditation?)

Years ago, I thought AABB inspections were much more thorough than CAP, but I don't have that opinion anymore. John's statement that "There are good inspectors & there are not-so-good inspectors" holds true for all of them - AABB, CAP FDA, etc. With my SBB and many (too many!) years of experience in Blood Banking, I think I do a respectable job as a CAP inspector.

[kmh76]

No we are a hospital lab and I also have 35 + years Blood bank Experience. No One is saying you are not a good inspector. In my opinion CAP inspectors that I have dealt with for 20 years just don't seem to do as thorough a job as AABB or Joint Commission. Like I said our last CAP inspector sat in Blood bank and watched. Never got off her **** to see a transfusion and never asked to look at any procedures or manuals. Just plain Lazy if you ask me. I can't judge all inspectors on the performance of 1 but in MY opinion AABB and JCAHO inspectors are much better. Our whole lab felt that way and we dropped CAP inspections.

[L106]

kmh76 - I understand what you are saying. It sounds like you've repeatedly had poor CAP inspectors, and I can understand why you dropped CAP accreditation because of that. You know, we saw a very brief period of lapse in CAP inspection quality a few years ago right after CAP instituted it's policy that if your lab was CAP accredited, you lab had to act as CAP inspectors for another facility's CAP inspection. Some labororians did not want to be inspectors (perhaps because of the time commitment, feeling unqualified, or just plain didn't want the hassle.) They were resentful that they were "forced" to do inspections, and consequently had poor attitudes and did poor jobs. It I think that all turned-around within a year or so, and since then our CAP inspectors have always been knowledgable and pleasant.

As I mentioned in an earlier post, we had several poor AABB inspectors (mainly back in the '80's), and I know that is not typical. (I think AABB has greatly improved their inspector training, and the vast majority of AABB inspectors are close to "experts" and want to help the inspected institutions improve their practices and quality of services.)

[kmh76]

L106

I understand and agree with everything you have said. Since we don't have CAP inspections anymore we now have to deal with a week long Joint Commission inspection. I don't know what's worse 1 day or 1 week!!!!!!!

[Eagle Eye]

CAP inspections used to be very easy ones but after MAryland experience, they are monitoring their inspection process. I always like AABB assessments but one of the post is right now a days most of the AABB assessors do CAP inspection also. Everyone has different approach to inspection process...you can read manuals or adopt Joint commission approach and do a tracer.

AS an assessor your goal is to make sure teh facility you are inspecting is meeting the standard/checklist requirement..there may be different approach then you are used to it but you need to keep an open mind and say are they meeting standarad requirement?? Each assesment should help to improve your process. ( I learn a lot when I go do an assessment..I always go back and look at the my system and adopt a better approach from others.

[KKidd]

Our facility has Joint Commission and AABB the same year. Where the JC inspector seemed to be looking for flaws(so we can improve), I had a wonderful chance to discuss many aspects of our transfusion service with the AABB assessor. My medical director has refused to drop AABB. As with everything these days it all comes down to money. I hope to continue with AABB but only time will tell.

l.

[Sheila]

"Our institution was accredited by both CAP and AABB "since the beginning of time", but we dropped our AABB accreditation about 10 years ago. Two things triggered that:

1. Back when AABB started the "Quality Plan" riggamarole, we jumped on board. I spent an enormous amount of time and effort writing up and organizing our Quality Plan. When our next inspector walked in, she looked at our impressive array of Quality Plan Manuals lined up on our shelves and said, "Oh, I see you have the Quality Plan stuff. I haven't seen any of that material yet." and proceeded to complete the inspection without so much as touching our precious Quality Plan "stuff". Prior to that, we had several AABB inspections that were of poor quality (ie: very superficial or the occassional ridiculously picky.) (I know this is not typically the case, but it was our experience.)

2. AABB's annual fees for institutions starting doubling around that time, and lab management & hospital administration decided that the hospital wasn't getting enough benefit for the money it was costing us and they decided to drop our AABB accreditation and membership. I was not supportive of this decision, but I can honestly say that I don't think it has made a bit of difference in the quality of our Blood Bank Department.

I am an individual AABB member, so I try to keep up with current information (so the hospital gets all the benefits even though we are not an AABB institutional member.) However, I don't know what will happen it my future successor is not an AABB member. "

THIS is why our institution dropped our AABB certification too. The inspector didn't even open the QA Plan notebooks and instead cited us for a couple of picky things. She was a physician and knew about as much blood banking as most do; in other words, practically nothing.

Since I am at a VA, we are FDA inspected and JCAHO inspected, as well as CAP. I don't miss the AABB assessments at all. I am an individual member so I can buy their books at member price.

[David Saikin]

As a small hospital blood bank which drew autologous (FDA licensed), we decided about 10 yrs ago to drop AABB. Like many have said, the bang for the buck wasn't there. I tried to get an associate membership, like John mentioned, but because we were FDA licensed, AABB said we had to have the full membership. As a long time inspector/assessor I maintain my personal membership, which we utilize to purchase education matereials, standards, and Technical Manual. For those of you who had initial negative experiences after the QP became active, yes it is a lot of work, Many AABB inspectors left the accreditation department due to the vagaries involved with assessing vs inspecting. Most assessors now are comfortable with the process. Personally, I like the assessment - the institution should be auditing their own processes for compliance. As an assessor, I am only monitoring your self-monitoring (and making certain you are in compliance with the standards). Anyway - my facility, at my prompting, dropped AABB. We also are not JACHO, but do have CAP.

[L106]

Anyway - my facility, at my prompting, dropped AABB. We also are not JACHO, but do have CAP.

David - Just curious: Since you are not inspected by JCAHO, are you inspected by any other organization besides CAP (such as the State?)

Donna

[nancy gurney]

As an AABB and CAP assessor for many years now, I've had the opportunity to grow as an assesor of both organizations. Both have training for assessors, although the AABB training is presented annually, face to face, and on a variety of assessment topics. The quality plan has been explained over the years. The first actual CAP training I received was only last year, and was web based. My own personal feeling is that the CAP section/ questionaire for blood bank is superficial, where the AABB assessment tool is comprehensive. I think Blood Banks are better if they subscribe to and use the AABB standards to help the quality of their blood bank.

[Likewine99]

We are CAP and not AABB. AABB was dropped about 15 years ago due to cost, we are comfortable with just being CAP accredited.

Staffing also factors in to this as our supervisors across the lab all have more than one discipline to manage and I function as BB sup and lab manager.

[skopti]

We are AABB and CAP accredited. We also get inspected bt the NYS DOH

[ChrisH]

We also are AABB and CAP inspected along with JCAHO. We have been thinking of dropping AABB.....

[kate murphy]

We are a hosp BB & Transf Service - FDA registered; inspected/assessed by FDA, AABB, CAP, JC, Homeland Security, etc.... I find there is some value is each assessment, though it is hard maintaining SOP/policies for all the requirements.

One large benefit to AABB is use of the National Blood Exchange. If you drop AABB, you cannot use the NBE or the rare donor file. Using NBE has allowed us to save millions annually, well worth the price of membership.

[shelleyk482]

The facility that I'm at now is fairly small and has never been AABB accredited. The 2 previous facilities that I worked, were both AABB accredited and while I was there, each facility dropped the AABB accreditation. My feeling is that when AABB went to the Quality Plan approach, the tools they decided upon were not really relevant to a Transfusion Service; for most hospital based TS, this became an exercise in paperwork that had little to no impact on quality. I have never had the luxury of working in a facility where I had the time or the staff to dedicate to a process that does not seem contribute to the concept of quality patient care. I do CAP inspections and for the most part, when I go into facilities their quality plan is "just a document that they had to write to meet regulatory standards". The manual is not used and is only updated immediately prior to an inspection.

Once AABB comes up with a tool that is useful for a hospital setting and doesn't take a dedicated Quality person, I may reconsider my position. Until then, I will keep my personal membership and continue to write and enforce policies and procedures that adhere to AABB standards without the cost and inordinate amount of paperwork of a facililty membership.

[L106]

Very well-expressed, shelleyk482, and I share you views.

[maxon]

We have both CAP & AABB and will continue to do both. We have the CAP as the rest of the lab areas want it, we in the blood bank would prefer to drop it. One of the main reasons is that we're afraid that if we drop a certification, our local competition will be more than willing to point it out to people as a way of gaining their business. Sad but true.

[silverblood]

Our hospital is no longer dropped it's AABB accreditation a number of years ago. The blood bank manager at the time did it without any discussion with the techs. in the department so when it was discovered it was a bit disconcerting. Since the manager in actaulity knew very little about blood bank, his reasons were strictly financial. We have survived but we always considered the AABB accreditation as a feather in our cap. The AABB inspections were far more grueling than CAP and more thorough. As they say, $$$$$$$$ talks..................we all know what walks..........